Category Archives: Moral Theology

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The tragic choice of Brittany Maynard for (physician-assisted) suicide (here are Brittany Maynard’s first and second videos) and of the response of Raleigh (NC) seminarian Phillip Johnson (see his open letter, “Dear Brittany: Our Lives Are Worth Living, Even With Brain Cancer”) draw into sharp relief two different views about how to handle suffering at the end of life. Both had aggressive forms of brain cancer. Both were terrified, as anyone would be, of passing through a horribly debilitating state before death and of the effect on their loved ones of seeing them in that state.

While it is important to give well-founded arguments against physician-assisted suicide, it is equally important to give a thoughtful, nuanced response to the problem and mystery of suffering as we encounter it in our society today. In an effort to consider this topic from a Christian perspective, I have introduced into my bioethics courses readings by and about saints on the problem of suffering and death. One such book is On Christian Dying by Matthew Levering. Reading through this book, one notices that some saints willingly—even eagerly—embrace suffering, that other saints strive mightily to avoid it, and that in each case, suffering is a very personal experience.

For example, consider the very different experiences of two martyrs: Saint Ignatius of Antioch and Saint Thomas More. St. Ignatius sounds positively gleeful that his execution might mark for him an “auspicious beginning” to eternal life “if only I obtain the grace of taking due possession of my inheritance without hindrance.” He writes the Christians in Rome not to intervene with Roman authorities to commute his sentence. Rather he asks “suffer me to be the fruit of wild beasts, which are the means of my making my way to God” (On Christian Dying 2-3).

Yet St. Ignatius’s letter to the Christians in Rome acknowledges the evil of his suffering, as when he refers to his guards as “wild beasts… who prove themselves the more malevolent for the kindnesses shown to them” (On Christian Dying 3). His words even suggest his own fear of a slow, agonizing death when he hopes that the lions finish him quickly: “Better still, coax the wild beasts to become my tomb and to leave no part of my person behind: once I have fallen asleep, I do not wish to be a burden to anyone. Then only shall I be a genuine disciple of Jesus Christ when the world will not see even my body” (On Christian Dying 3). But does St. Ignatius seem a bit too eager to die? Perhaps he fails to appreciate the goodness of remaining in this earthly life. Or perhaps his eagerness is explained by the fact that he is a bishop and recognizes the need to set a perfect example of the willingness to accept martyrdom rather than abandon his faith to escape persecution.

St. Thomas More was also motivated by the need to set a faithful example for his fellow Christians, but he hardly displayed St. Ignatius’s eagerness to be a martyr. More was sentenced to death for refusing to acknowledge Henry VIII’s supremacy over the Church of England and spent the days before his execution in the tower of London, where he wrestled with his own fear and sorrow by meditating on Christ’s final hours. He writes to console himself and to edify anyone who might later read his writings. He earnestly did not want to die, observed that Jesus didn’t either, and struggled to share Christ’s willingness for self-sacrifice. More takes Jesus’s fear as “evidence” that fear and avoidance of death is entirely natural and proper to human beings.

As averse as he is to suffering death at the hands of his executioners, More never accepts sin to avoid death. Rather, he recalls Saint Paul’s comforting words to the Corinthians: “God is faithful, and he will not let you be tempted beyond your strength, but with the temptation will also provide the way of escape, that you may be able to endure it.” (1 Corinthians 10:13) Then he wrote, “[W]hen things have come to the point of a hand-to-hand combat with the prince of this world, the devil, and his cruel underlings, and if there is no way left to withdraw without disgracing the cause, then I would think that a man ought to cast away fear and I would direct him to be completely calm, confident, and hopeful.” (On Christian Dying 83)

With these words Saint Thomas More brings us to one of the most difficult decisions a person can make, the decision to confront intense suffering without compromising moral integrity. He had to accept hopefully a different life than the one he had planned when tragedy was thrust upon him. In his weaker moments, being “completely calm, confident, and hopeful” was more aspiration than reality. But the way he died displayed a deep faith and a willingness to wrestle with the problem of suffering and death. I do not know what Britney Maynard’s faith commitments were and have no judgment to make about her existence now. At the same time, her videos do not express a grappling with the problem of suffering that each person must at some point confront. Perhaps she did. I hope so and would like to know what she thought. I do know the faith commitments of seminarian Philip Johnson. When his diagnosis dashed hopes and dreams, he did the hard, messy work of discerning new reasons to live. Thank you, Philip Johnson, for your example.

Grattan Brown teaches Ministry to the Sick and Dying for Saint Joseph’s College Online.

In January 2011 I was giving a presentation on bioethics at my parish, and just after the presentation started a man hobbled in on a cane. A few months later I was giving another presentation on the same topic, and a man entered the room in a motorized wheelchair. I puzzled for a few moments because it looked like the same man. As I continued with the presentation I realized that it was indeed the same man. It was rather unnerving to be able-bodied, in good health, and speaking about ethical issues so closely related to the suffering of the sick, while this man, who was clearly suffering from a debilitating disease, was there listening intensely. I couldn’t help wondering what it was like to be grappling with these issues “from the inside”—so to speak.

Marty and I met soon afterwards. We discussed our common interests and goals: we were both striving to be good husbands and fathers. Marty recounted stories of work and play around the horse farm where he and his family live. He spoke about arranging horse jumps for his daughter Cecilia, clearing brush from the woods behind the house, laying up firewood for the winter, cleaning out the horses’ stalls, and myriad other chores. In our discussions about bioethics he drew upon his medical expertise, built up over eleven years as a successful, interventional radiologist.

Marty was also interested in my literary and theological background. He asked me to read the rudiments of his spiritual autobiography. I asked questions that prompted him to think more deeply about the meaning of the joys and sufferings he was experiencing. At times I felt as though I was giving him “work” to replace the professional life lost to ALS. And what a “worker” he has been! His spiritual autobiography, Joy and Suffering: My Life with ALS, was dictated through an iPhone into emails, initially, and then into a document that was edited by Christian Tappe of St. Benedict Press.

Photo of D’Amore Family at Lou Gehrig’s Disease – ALS website

In many ways, Marty is a typical American guy, but there is definitely something special about him. He is inspired by the meaningful lives other people lead, for example, by the doctors who first showed him the beauty of a medical career and motivated him to pursue it. He has been given given plenty of natural intelligence and talent, and as a young man he struggled to discover and develop himself. He worked hard at his profession, marveled at the good he could do with it, and reaped its rewards. He has been wildly successful—by American standards—in his profession, family, and lifestyle.

More importantly, Marty demonstrates a kind of spiritual excellence. Not the spiritual excellence of the great ascetics of history, who master temptation with an iron will honed through self-denial. Rather the spiritual excellence of one who has prayed with a child’s trust for a good life, lost himself in the confusion of growing up, found the way his talents could lead to success, and finally, as he achieved success, recognized something missing even before detecting the first symptoms of ALS. ALS focused his heart and mind on another kind of success: developing spiritual maturity. By slowly eliminating his physical mobility, ALS forced Marty to find new ways to love his wife, children, and friends. His book offers Marty’s explanation of what he has learned in the hope that his family can discover, with him, some joy within the tragedy that has befallen them all.

Spiritual conversion is the stuff of great literature and epic poetry, but we are not usually given the privilege of a guided tour of this process unfolding in the lives of our neighbors and friends. We all change profoundly as we move through life, and know that our neighbors change in similar ways, but rarely do we get the opportunity to understand that change from the inside. In Joy and Suffering: My Life With ALS, Marty describes the experience of suffering with ALS, depicting not only the intricacies of the disease but also the hard-won meaning of the suffering it has brought him and his family.

This blog post was adapted from the Foreword to the book Joy and Suffering: My Life with ALS by Martin J. D’Amore.

Grattan Brown teaches Ministry with the Aging, Sick, and Dying for Saint Joseph’s College Online.

Update: Marty D’Amore died on January 28, 2015 surrounded by friends and family. He was laid to rest in Belmont Abbey monastery cemetery, a few 100 yards from the chapel where he often prayed.